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目的对2009-2014年学校甲型H1N1流感聚集性疫情流行动力学特征分析和抗体水平监测,探讨二者相联性,揭示疫情传播规律,为流感新病毒的科学防控提供理论依据。方法对深圳市龙岗区2009-2014年中小学校甲型H1N1流感聚集性疫情流行特征进行描述,用累积病例数对感染天数进行曲线拟合并求导计算即时传播速率,对指标进行相关分析,计算基本再生数R0。结果 2009-2014年学校甲型H1N1聚集性疫情60起,病例数1 034例,平均罹患率10.50%,67.12%的病例发生在小学人群。聚集性疫情基本再生数R0为8~10,高于社会一般人群。2009年人群抗体水平极低(阳性率为10.00%,GMT:22.45),疫情高发(52起,979例),人群病例即时增长速率高达29.5人/d,单起疫情规模6~80人不等,持续时间1~23d不等,疫情易于从单个班级向全校扩散。2010-2014年平均抗体水平阳性率为64.33%(GMT:74.32),疫情相对较少。仅在2013年3月抗体水平相对较低(GMT:41.75)时发生小幅活跃疫情,人群病例以平均速率1.46人/d的低速率线性增长。聚集性疫情数与抗体水平呈负相关关系(rs=-0.934,P<0.01)。结论学校人群是流感新病毒传播的高危场所,学校聚集性疫情流行强度和动力高于社会一般人群,疫情的发展态势取决于群体的抗体水平。在应对流感新病毒时应全面监测疫情的传播动力特征和人群抗体水平并评估疫情态势,(在疫苗安全的情况下)尽量制定和采取以疫苗接种为主的特异性防控策略和措施。
Objective To analyze the epidemiological characteristics and antibody level of Influenza A (H1N1) epidemic in schools from 2009 to 2014, explore the association between them, and reveal the regularity of epidemic spread, so as to provide a theoretical basis for the scientific prevention and control of new influenza virus. Methods The epidemic characteristics of influenza A (H1N1) epidemic in primary and secondary schools in Longgang District of Shenzhen City during 2009-2014 were described. Curve was fitted to the days of infection with the cumulative number of cases, and the calculated real-time transmission rate was calculated. Correlation analysis was performed to calculate the index Basic reproduction number R0. Results From 2009 to 2014, 60 cases of A (H1N1) outbreaks were reported in schools, with a total of 1 034 cases, with an average attack rate of 10.50%. A total of 67.12% of cases occurred in primary school. The basic reproductive R0 is 8 ~ 10, higher than the general population. In 2009, the level of antibody in the population was extremely low (positive rate was 10.00%, GMT: 22.45), and the outbreak rate was high (52 cases, 979 cases). The real-time population growth rate was 29.5 persons / d and the single-case outbreak ranged from 6 to 80 , The duration of 1 ~ 23d range, the epidemic is easy to spread from a single class to the school. The average antibody positive rate in 2010-2014 was 64.33% (GMT: 74.32), with relatively few outbreaks. Only a modestly active outbreak was observed when antibody levels were relatively low (GMT: 41.75) in March 2013 and the population of patients increased linearly at a low rate of 1.46 individuals / day at an average rate. There was a negative correlation between the number of aggregated epidemic and antibody level (rs = -0.934, P <0.01). Conclusion The school population is a high risk place for the spread of new flu virus. The epidemic intensity and motivation of school-centered epidemic is higher than that of the general public. The development of the epidemic depends on the antibody level of the population. In response to the new flu virus, the epidemic dynamics and population antibody levels should be fully monitored and epidemic situation should be assessed. Specific vaccination-based prevention and control strategies and measures should be formulated and adopted (in the case of vaccine safety).